Getting Started with Continuous Glucose Monitoring: Your First Steps

person getting started with cgm

The first blood glucose test strip was invented in 1965 while the first at-home monitor wasn’t introduced until 1980. The introduction of self-monitoring of blood glucose (SMBG) using finger-stick blood samples gave control back to diabetics. 

But, just because it was first doesn’t mean it’s best. Continuous glucose monitoring was introduced at the turn of the millennium—AKA 1999. And, as the technology continues to advance, it has become another game changer in diabetes management. 

For individuals seeking a more dynamic and proactive approach to understanding their glucose levels, CGM is a revolutionary tool. If you’re considering a continuous glucose prescription, you’ll want to follow these first steps. 

From initial considerations to seamless integration into daily life, each step is a gateway to enhanced understanding, control, and empowerment through better blood sugar control. 

Step 1: Consult with Your Healthcare Provider

Before you can embark on your journey toward better blood sugar control and grab that CGM prescription, you need to take a crucial first step—engaging in a comprehensive discussion with your healthcare provider.

This initial consultation is not just a formality but an important conversation to ensure that switching to one of the available continuous glucose monitoring devices actually aligns with your unique health needs and goals.

Your healthcare provider takes into account several important factors, including your: 

  • Current diabetes management regimen
  • Current lifestyle
  • Medical history

They can also discuss what to expect when using a CGM device so that you are making an informed decision, which leads us to step two. 


Step 2: Understand CGM Systems and Components

Before you can decide whether a CGM device might be the right choice for you, you need to understand how continuous glucose monitoring devices work. CGM systems typically consist of three primary components:

  1. Sensor: The sensor—a small, wearable device that is discreetly placed beneath the skin—is the heart of the CGM system. It’s how you keep track of blood sugar levels. This sensor continuously measures glucose levels in the interstitial fluid, providing real-time data on fluctuations throughout the day and night. There are two types of sensors: disposable sensors replaced every 7-14 days, and implantable sensors replaced every few months. 
  2. Transmitter: Working in tandem with the sensor, the transmitter communicates with the sensor to wirelessly transmit glucose data. This is a wireless functionality that relays information to either a dedicated receiver or a smartphone app. Real-time devices will relay this information automatically. Intermittent devices, or flash glucose monitoring (FGM) devices, need to be scanned with the receiver to relay the information. 
  3. Receiver or Smartphone App: Some CGM systems come with a dedicated receiver, while others leverage smartphone apps for a more connected and user-friendly experience. The receiver or smartphone app is where the data from continuous glucose monitoring devices is gathered. This is where you can access and interpret your CGM data, including real-time glucose levels, trends, and historical data.

Depending on your current needs, you may need to consider different components as well:

  • Insulin-dependent diabetics may want a CGM device that will integrate with their insulin pump. 
  • If you struggle with high or low blood sugar fluctuations, you may want a device that allows for personalized alerts. 
  • You may also want to ensure the receiver or app can share data with your healthcare provider for even more individualized care. 

Step 3: Get a CGM Prescription and Necessary Equipment

Once you and your healthcare provider have determined that a CGM device is the right choice for you, it’s time to get your continuous glucose monitoring prescription. Even with the CGM prescription in hand, it’s important to check your insurance coverage for CGM

Many insurance plans cover at least a portion of the costs associated with CGM equipment, while many will cover it in its entirety—as long as you have a diabetes diagnosis. 

If you are prediabetic or looking to use your CGM for weight loss, insurance is not likely to cover the device. If paying out of pocket, the CGM cost will vary, but is typically upwards of $250 per month. 

Once you’ve determined your coverage and what continuous glucose monitoring devices are covered, you can select a supplier and order your CGM. 

Remember these are typically disposable devices and will need to be replaced every 7-14 days depending on the device. So, your CGM prescription will include two to four sensors per month depending on the frequency it needs to be changed. 

You will receive the sensor (which includes a transmitter), the receiver or instructions on how to download the smartphone app, and a sensor applicator. Generally, the supplier will also include information to familiarize you with the setup, insertion, and usage of the system.

Step 4: Set Up Your CGM System

Now that you have your CGM device, you’ll need to insert the sensor and set up the system. Each device will have its own set of steps to follow and it is very important to adhere to the manufacturer’s guidelines during the setup process.

Generally, you’ll want to follow these steps:

  1. Gather your supplies. First, you need to gather all the necessary supplies, including the CGM sensor and its applicator, alcohol wipes, and any additional items specified by the manufacturer.
  2. Prepare the sensor. Remove the sensor applicator from its packaging and set it up so that it is ready for insertion. Check for damage to the device and follow any manufacturer instructions provided. 
  3. Wash your hands. While the insertion site may be small, there is still a risk of infection. So, you should wash your hands before you begin this process. 
  4. Prepare the sensor site: Choose a suitable site for sensor placement, following the manufacturer’s guidelines. Common locations include the abdomen or upper buttocks. Ensure the chosen area is clean and dry before proceeding. 
  5. Apply the sensor: Carefully apply the sensor to the selected site, following the specific instructions provided by the manufacturer. Secure the sensor in place with the provided adhesive patch, ensuring it forms a snug but comfortable fit on your skin.
  6. Connect to receiver or app: Whether you have a dedicated receiver or use a smartphone app, connect your device to the receiver. Follow the instructions provided by the manufacturer to establish a seamless connection.

If you encounter any challenges during the setup process, consult the user manual for troubleshooting guidance. Manufacturers often provide comprehensive resources for users. Still, sometimes the problem can’t be solved alone. If you need additional help, reach out to your healthcare provider for assistance as needed.

Step 5: Calibrate Your CGM System

While continuous glucose monitoring devices eliminate the need for regular fingerprick tests, they do still require calibration. And, the best way to calibrate your CGM device for accurate glucose measurement, is a fingerprick test. 

Your manufacturer should provide step-by-step instructions on how to calibrate your CGM system. It is important you follow these steps exactly to ensure accurate calibration. 

Why do you need to calibrate? Your CGM device needs to convert the raw measurements to an accurate glucose value. The fingerprick tests help inform the algorithms to provide accurate readings. 

While each device will have its own set of instructions, generally you will need to:

  • Use your blood glucose meter to obtain a blood sample.
  • Access the calibration settings on your CGM receiver or app and input the blood glucose reading.
  • Some CGM systems may require multiple calibrations throughout the day to begin, so repeat as necessary.

Step 6: Interpret Your CGM Data

You’ve inserted your sensor, calibrated the system, and now you’re receiving a continuous stream of data. What next? It’s time to start interpreting the data and using it to make adjustments to your diet, lifestyle, and medication. 

You shouldn’t make any big decisions without consulting your healthcare provider, but you can make small adjustments to your diet and exercise routine to try and maintain normal blood sugar levels

  • During the initial setup phase, compare CGM readings with those obtained from your blood glucose meter. This correlation helps you establish a baseline for accuracy and gain confidence in the reliability of your CGM system.
  • Pay attention to the overall trends in your CGM data. Are your glucose levels generally stable, trending upward, or trending downward? 
  • Pay special attention to your CGM data around mealtime. Note how your glucose levels respond to different foods and the timing of meals. 
  • Watch how exercise and stress impact your glucose readings. Do some exercises spike your glucose levels?
  • Utilize the alert features on your CGM system to notify you of specific glucose thresholds. These can help you prevent hyper- and hypoglycemia. 
  • If you notice consistent patterns or have concerns about your CGM data, consult your healthcare provider. If you’re unsure how to interpret the data and make adjustments, you should reach out to your doctor as well. 
  • Familiarize yourself with key metrics provided by your CGM system, such as time in range, time above range, and time below range. 

Step 7: Integrate CGM into Your Diabetes Management Routine

As you become familiar with interpreting your continuous glucose monitoring (CGM) data, the final and pivotal step is to seamlessly integrate this newfound knowledge into your daily diabetes management routine.

It sounds like something easier said than done. But, once you’re comfortable reading the data your CGM device provides, it can be simple to start making decisions based on the trends. 

  • Meal planning: Leverage your CGM data to make informed choices about meal planning. Recognize the impact of various foods on your glucose levels and adjust your dietary choices accordingly. 
  • Physical activity: Understand the influence of physical activity on your glucose levels by reviewing CGM data during and after exercise. If there are some activities that negatively impact your glucose levels, consider removing them from your routine. 
  • Personalized alerts and notifications: Customize your CGM system’s alerts and notifications to align with your daily routine. Set reminders for specific glucose thresholds or time intervals to prompt proactive actions.
  • Establish baselines and goals: Utilize CGM data to establish baseline glucose levels for different times of the day. Set realistic goals for time in range, time above range, and time below range. 
  • Collaborate with your healthcare provider: Work closely with your healthcare provider to develop personalized CGM-based treatment strategies. 

Control Your Blood Sugar Better with a CGM Prescription

Continuous glucose monitoring devices do require a prescription, regardless of whether you’re using the CGM for weight loss or diabetes management. So, you will need to consult with a healthcare provider. 

The real-time insights, personalized data, and collaborative approach with healthcare providers create a synergy that goes beyond managing diabetes. Take control of your diabetes—with help. 

Heally can connect you with doctors who provide specialized support and guidance from initial consultation to integrated diabetes management, or just to understand the results. Get started today!


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